1. IX- PREPARING THE BUDGET
Process of translating inputs, targets, and activities into money.
Purpose: To identify financial requirements by the plan period and individual year, by specific program and enable performance budgeting.
Each health care provider should state how much funds they have available according to the program and details of each specific line item(activity) within the program.
If health plans are made for 5 years, all the expenditures required to make the system work over 5 years have to be included.
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2. If implementation of a government plan(macro plan) within the district is the plan, those program components that are not covered need to be added.
If plan is to include additional activities to routine services program components, then first review strategies and activities associated with the program e.g. maternal mortality.
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3. Steps for preparing Budget
1. Review previous years budget. Assess level of expenditure and compare with service targets set in the plan.
2. Service objectives and targets my require modifications in the light of previous years performance
3. Carefully read the current plan and identify all activities consuming resources e.g. in reducing maternal mortality the activities are: ( train new TBA,s provide new equipment and transport and repair old one, salary for the staff, consumables and utilities.
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4. BUDGET ( CONT)
4.See whether the line item falls in the category of Capital budget(one time only) or Recurrent budget (required repeatedly)
5. Convert line items(activities) into money–try to find out the unit cost of each activity e.g. 1 unit cost of construction will be the cost of constructing one square foot or meter of building. Unit cost for training will be the cost per participant trained in a 10 days workshop.
6. From unit cost compute total cost.
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5. Contingencies(unforeseen eventualities) should not be more than 10%
Line Flexibility (within 10%)funds can be re allocated form one activity to another if justified. e.g. funds available from the salaries against vacant positions can be reallocated for purchase of drugs if there is cost escalation during the budget year.
•Performance based budgeting: Powerful tool for evaluation. Compares planned with actual expenditures
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6. X- DEVELOPING THE PLAN OF OPERATIONS
This is the written summary of the implementation plan specifying main objectives, expected results and activities. Following issues must be addressed:
1. What is to be done?
2. How that has to be done?
3. By whom ?
4. To whom?
5. When ?
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7. 8. Over what period of time? 9. Measures taken for quality control ?
6. How often?
7. Through what means?
8. Over what period of time?
9. Measures taken for quality control ?
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8. Identify major activities, new content to be introduced, target population, health cadre responsible, frequency of activity, time and locality of services, their duration and additional resources required.
One of the most useful tool in the preparation of plan of operations is GANTT chart. It tells at a glance information about what has to be done, when such has to be done, where in relation to plans current operations are and where to missed or delayed activities might be shifted to.
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10. It shows major activities that need to be implemented at specific times if the program is to achieve its objectives within a given time frame.
Next planners need to identify indicators for measuring to what extent activities have been achieved and tools of verification. They also have to identify person responsible for the report, frequency of reporting and feedback.
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11. XI -PLANNING FOR MONITORING AND EVALUATION
Monitoring and Evaluation (M&E) is a quality control mechanism and forms part of M & O responsibilities.
Purpose: To render health care as efficient and effective as is possible within given ecological and resource constraints.
Planning for M & E means preparing for quality control activities before implementing the actual plan.
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12. 1. Whether objectives and expected results are being reached?
M & E serve to assess whether first four components of health care delivery system ,input, input distribution, outputs, outcome as well as the support and M & O systems are in place, are functional and match earlier established quality criteria.
Helps to determine:
1. Whether objectives and expected results are being reached?
2. Whether plans are being implemented the way they were planned to be implemented?
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13. 2. Identify problems early enough to allow corrections.
1. Ensure that all components of Health Service Delivery System (HSDS) are in place and are functional
2. Identify problems early enough to allow corrections.
Monitoring refers to an ongoing process carried out by the plan “implementers”(persons from government, or a health care facility).limited to the process.
Evaluations are carried out less frequently usually done by a personnel from a higher level of government as MoH or donor agency. It includes process and impact. Evaluating how the impact has been reached is “process evaluation”.
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14. Program monitoring should include areas like:
To determine whether the main or principal objective has been reached is referred as “impact evaluation”.
Program monitoring should include areas like:
1. Periodic/ continuous check on quality, quantity, timeliness of activities.
2. Regular feedback and correction of detected weaknesses, inadequacies.
3. Ongoing assessment whether objectives can still be reached.
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15. For that individuals involved in monitoring process should be identified, periodic data collection should be planned, special attention to monitoring of resource availability. Areas for monitoring need to be identified which require special knowledge and skills.
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16. PLANNING FOR MONITORING AND EVALUATION (Contd)
Monitoring requires:
1. Availability of a functional supervision and in service training program for all the staff.
2. A functional and up-to-date HMIS.
3. Availability of agreed chronology of events showing a relationship of all programs and activities to time (Gantt Chart).
Planners need to identify indicators for measuring to what extent activities have been achieved and tools of verification. Identify persons responsible for the report ,frequency of reporting and who is to provide feedback
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17. AREAS TO BE MONITORED
1. Support Systems(drugs, supplies, transport, repair and maintenance)
2. Management and Organization (M&O) System (training, supervision, HMIs continuity, comprehensiveness and accuracy.
3. Health Service Inputs(Availability of services in terms of days, physical infrastructure, staff, budget)
4. Service Input Distribution.(mobile services)
5. Service Outputs.(quantity and quality of services, staff knowledge and skills) In the end a “plan document” should be handed over to those responsible for planning.
Tuesday, November 13, 2018